Tuesday, December 30, 2008

I just finished a lovely hour reading Can't Spell, DVM's blog. Contrary to her title, she can indeed spell, mostly. And the stories are definitely worth a look.

Which reminds me: one thing that people always say to me, when I start talking about critters (especially dogs), is "Why didn't you become a vet?" The answer is very simple: I can't stand to see an animal in pain or afraid. People don't bother me a bit, because people can mostly understand words--or, if they can't, because of a stroke or brain tumor or whatall, they still retain basic human understanding of things like touch and smiles and singing. Critters in pain flip me right the hell out. I have no clue what to do and react badly.

Once, manymany years ago, Evvie-cat got her front leg stuck in the crack of a staircase and hung up on an old twenty-penny nail. I was in hysterics as I called the mobile vet (thank Frog for mobile vets!). Dr. Mobile came, dropped a towel over her head, unhooked The Flannelcat from the nail, shot her up with antibiotics and maybe a tetanus shot (I may be remembering that wrong; somebody please tell me if cats can get tetanus), and earned my undying gratitude for two minutes' work.

The point here is that I have no trouble at all dealing with a generalized tonic-clonic seizure, a bleeding arterial puncture (which is more like a fountain than a bleed), a patient who's fallen and is unconscious, a code, or even a traumatic amputation. One injured animal, though, would send me over the frigging edge.

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Speaking of vets, mine has a pet kangaroo that somebody abandoned at the clinic.

Now, we're in Texas. Texas is a long way from Australia, which is where kangaroos are, as far as I know, from. I suppose you could import a kangaroo, but let's be serious: what would you then do with said kangaroo?

Apparently the kangaroo loves the vet and hates everybody else.

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I think I've come up with Nurse Jo's Perfect Formula for Surviving A Nasty Cold: Delsym (grape flavor is actually not so bad!) ibuprofen, Mucinex (plain, please; don't overdose on dextromethorphan or go with unnecessary decongestants), soup, and Vick's Vaporub.

A happy puppy and a plate of cheese sticks go a long way, too. So does a glass of wine.

Wups! Happy Puppy is asking to be let in. Hang on...

*** *** *** *** ***

...so. The Cat Thing.

This house feels terribly empty without a cat.

I think my birthday gift to myself will be a cat. The birthday is two months from now; I figure that's time enough to get over the bleak feeling of having done a cat-avoidance shuffle-step when there is no need, or of checking the couch before I sit down.

I'm going to get a cat that doesn't rush the door. It doesn't have to be a kitten, though the first crop of them will probably be showing up in the shelters in late February. It *does* have to be a shelter cat. And it will be spayed or neutered and NOT declawed. Furniture is temporary; cut-off finger-ends are forever. Future Cat and Max will learn to deal with one another.

*** *** *** *** ***

And speaking of Max, he's a wonder. Does anybody else have a Bullfrog Dog who goes "MMMMMmmmmmmMMMMMMM" when you rub his ears? His nickname these days is Mister Hayes.

*** *** *** *** ***

And, finally, a link I found at Can't Spell, DVM that is totally worth reading: LPN with an M16.

Be well, Army LPN. Come back to us in one piece. Bridge to an RN. I would be more than proud to work with you.

I felt unreasonably lighthearted when I woke up this morning. Then I started coughing; a deep, chesty cough that leaves me sounding like Harvey Fierstein and Eartha Kitt's love child. That combination warns me that I need to stock up on Delsym, decongestants, and zinc, for a cold is definitely on its way.

Of course, I also don't have to go back to work until Friday. My boss, with a quickness and sensitivity that left me floored, gave me a mental-health day off today.

Being a nurse gives you plenty of opportunities for gaining perspective. The day after Evvie died, I went back to work. One of my patients had a hyperventilating drama-queen attack about having four staples taken out of her head. I sent another patient to ICU before 8 am so he could be intubated, placed on a fentanyl drip, and sedated in order to control the pain he was having from widespread bone cancer.

It's also nice to have a job that takes up the majority of your day and leaves you so exhausted at the end, mentally and physically, that any emotional pain that you have feels like it's happening to somebody else. The last few days have sucked big jaggy rocks, yes, but they would've sucked more had I been a waitress or a checkout clerk or an accountant. Or, frankly, if I'd stayed home and stared at the empty couch and wept.

As it was, I ran around like a chicken and solved problems and passed meds and changed dressings and, while I didn't smile much or make a lot of jokes, I was at least functional.

*sigh*

The next few weeks will be tough. The hardest part of this has been watching Max react to the fact that there's no cat in the house. Max grew up with dog-loving cats and had always treasured the hope that Evvie would someday like him; he keeps looking for her behind the couch and the Christmas tree. Watching him search behind things with his tail wagging, then watching the wag slow and stop and the tail droop...it's hard.

But. Eventually there will be another cat. With luck, it'll be a Max-friendly cat.

And in the meantime, I'll stop over at the neighbors' house in the next couple of weeks and offer to help them dog-proof their fence for real.

Friday, December 26, 2008

The postman came to deliver a 50-ounce reservoir for the pet fountain I'd gotten Evvie. She must've slipped out the door while I was taking the thing. She never went out in the front yard, only in the back, where she stayed inside the fence with Max.

The first inkling I had that something was wrong was a scuffle in the bushes outside the office. I heard a growl and a larger scuffle, and ran outside without even realizing why. There were the two dogs from across the street, Sammy and Veruca, with Evvie in between them.

They broke her back, or her neck. At any rate, it was quick. I chased Veruca out of the yard and across the neighbor's yard--she had Evvie in her mouth--and managed to scare her off on the other side of Preacher Paul's yard. Evvie was already dying at that point.

She didn't seem to be hurting. She was stretched out on her side, breathing slowly, and I petted her head and told her she was a good kitty and that I was there with her. She coughed three times, I guess because she started to fibrillate, and then her body relaxed and she was dead.

It's not all that different with a cat than it is with a human.

The woman--girl, really--who was in the house was much more freaked out than I was. I don't blame her, or the dogs...the dogs were doing what their breeds *do*. They hopped a huge chain-link fence to get out and run around, and Evvie just happened to be in the wrong place at the wrong time.

I wrapped Evinrude up in a pillowcase and buried her in the back yard, in a corner of the garden. Maybe I'll put some horrible little cat statue over her grave. In the meantime, though, there are cement stepping-stones over it to keep Max from digging. He was quite confused and concerned about the whole thing.

Evvie was thirteen. She was a horrible cat. She never caught a mouse in her life, and was prone to slash and bite without warning. Occasionally she would deign to let some privileged human, like Chef-Boy, pet her while she was on their lap. She hated dogs, vacuum cleaners, and brooms. She peed on the rug and scattered her food and water everywhere. She shed like a beast.

Just before the postman knocked, she was stretched out, full-length, on my belly. She was letting me play with her paws, and purring. I'm glad she didn't die when I was pissed off at her, or when she had an empty belly or was cold. I loved her, in spite of her.

(Yes, I did make a nine-foot-long stuffed pink Colossal Squid out of Minky fabric for Chef-Boy. Yes, I do have pictures. Not very good ones at this point, but some. Once we get more pictures of Squidly [we plan to pose him sitting at the computer, on the couch, driving, etc.] I promise to post them.)

(Also, please don't ask me for patterning advice on Squid. I did it on the fly, cutting away the bits of fabric that weren't Squidlike. It's testament to my nonexistent sewing skills that the damn thing turned out approximately one-third larger than I had intended it to. Six feet by two? That's a manageable squid. Nine by three? Not so much.)

Tuesday, December 23, 2008

Every year at Sunnydale, we have a big Christmas party. I mean *big*. Our floor feeds all our employees, the employees from various other departments, and sundry patients and family members. We plan the thing for weeks in advance and everybody chips in.

There are rules. If you don't bring enough food to feed a minimum of twelve folks (or one hungry resident), you have to pony up cash. There's no set amount, but whatever is given should be given without our having to pester you or your whining about it. Likewise, if you didn't bring something or pay money, you don't get to take any leftovers home. And, finally, we leave the vast majority of food for the night shift and residents, who reciprocate throughout the year.

Sounds reasonable, right? And you know where this is going, right?

I have two coworkers: The Thiever and The Bitcher.

The Thiever steals anything and everything that isn't tied down: potted plants, toilet paper, items left unclaimed in the lost and found, people's empty totebags that are left a moment too long, clean Tupperware from the kitchen. I understand that two kids and a deadbeat husband can make things tight, but c'mon. There is a limit.

Plus, she hates giving money for parties and doesn't cook.

The Bitcher has not--and here I do not exaggerate, for once--ever eaten anything besides meat and starch in my presence. Everyone else's food is fair game for her wrinkled nose and expressions of disgust. Vegetables are a foreign concept, as is any cheese that is not processed. She lacks even the most basic dinnertime manners. She would give my mom a heart attack.

Plus, she hates giving money for parties and doesn't cook.

I know you can see the end of this tale, like the steeple of a church rising up from the Alberta horizon, but bear with me. My blood pressure is insanely high.

Friday was the annual Xmas Do. Those of us who cook spent hours preparing food (and a good chunk of our own change), setting up the tables, and making sure things were hot. There was a turkey. There was a ham. There were various side dishes including, but not limited to: greens, macaroni and cheese, scalloped potatoes, mashed potatoes, dinner rolls, bean casserole, an enormous green salad with walnuts....you get the idea. I made four pies and a cake for the dessert course. We rocked out.

Come afternoon, The Thiever arrived with--and again, here I am not exaggerating--a stack of plasticware and a couple of trash bags, and proceeded to scrape, pile, dump, and ladle all of the leftovers she could fit into the plastic containers. This after not giving any money or time to the party fund or even bothering to show up for the damn thing.

The Bitcher joined her in the kitchen and offered a running commentary on what was good, what was bad, and what was just plain too weird to eat.

I was washing dishes and so got to see and hear the whole thing. After hearing my beautiful Potatoes Savoyarde denigrated as being "funny-tasting" (that would be the Gruyere, thanks), I lost it. I put down the sponge and grabbed the plastic container with the half of an apple pie in it.

And I snarled, "Get OUT." Like a pink-eyed pig on a fire escape, I was.

I was met with expressions of disbelief.

"Neither one of you," I hissed, "Did one fucking thing for this party. You" (stabbing finger at The Bitcher) "refused to eat anything without complaining about it. And you" (ditto at The Thiever) "didn't bother to show up, pay even five bucks, or cook anything. You do not get leftovers. Bitcher, you do not get any more food from me."

"I am not done cooking, but I am done cooking for you two damn fools."

And with that, my beloved, blessed, wonderful coworkers, who had heard the whole thing, all stood up silently and began to unload the various plastic tubs and boxes from The Thiever's bags and return them to the fridge for the night shift. The Bitcher stood there flummoxed and protesting that she was only joking, but everybody ignored her.

And on Christmas Day? When we're all working together again and a few of us are bringing breakfast?

My two worthless colleagues will have to brown-bag it or buy something from the vending machines. I am *through*.

Saturday, December 20, 2008

A friend of mine (let's call her Jan and say she's an accountant, shall we?) told me on the phone that one of her coworkers had developed some worrying symptoms while at work. She'd suddenly been unable to remember anything beyond showering that morning, her speech became slow and her thought processes confused, and she began to drag one foot.

Jan told me that they sent the woman home with her husband. I told Jan--trying my best not to be judgmental, because Jan is in no way associated with the medical profession--that she should've called 911, that those were the symptoms of a stroke.

Jan replied, "We tried to convince her, but she wouldn't let us call the ambulance."

And here's the PSA part of this post:

The next time somebody you work or live with exhibits symptoms like speech difficulty, memory loss, numbness or tingling on one side of the body, gait disturbances, or simply something that seems "off"--like a really bad headache--call 911.

It doesn't matter if they want you to or not. This is a "Fuck you, I'm calling 911" moment.

See, with strokes, there's a really, really limited amount of time during which treatment can do any good. With ischemic (clot) strokes, it's in the neighborhood of three hours. With hemorrhagic (bleeding) strokes, it's even less--time is of the essence in either case.

And, quite frankly, the person with the symptoms does not get to make the decision on what's appropriate. They're the ones having the symptoms, right? Uh...yeah. And their brain is already not right.

It's really hard not to make somebody like Jan feel defensive when you say, "Listen: next time, just call 911, okay?" It's also really hard to make the decision to call when the person you're calling about is quite upset that you would do such a thing. And, of course, there's a whole 'nother level of bumblefuck that ensues if the person with the symptoms gets it together enough to refuse ambulance transport.

The point here is that you only have one brain. What you do with it is your business, of course, but if you notice something off-key with your own or another person's brain, it's the responsible thing to do to notify people who have good drugs and machines that go beep. If it's a false alarm, dandy. But if it's not, and you send that person home to sleep....

Well. Jan's coworker is fine. What she had was either (probably, since I'm no diagnostician) a TIA or an atypical migraine. Jan and her other coworkers are still encouraging her to see a doctor next week.

Friday, December 12, 2008

Saturday, December 06, 2008

Nurses can, as I illustrated in my last post, be jerkwads who jump to conclusions.

Every once in a while, though, somebody goes above and beyond and says something that makes me go *blink*.

About a young, gay, HIV+ guy I was taking care of: "You have to watch out. Those people will try to spit on you or bite you and give you the AIDS."

Me: *blink*

About a young female sex worker with a galloping case of CNS cancer: "What do you expect, with a lifestyle like that?"

Me: "Tell that to the chick in the next room." (A young female Evangelical Christian missionary with, you guessed it, a galloping case of CNS cancer.)

About a woman who topped 400 pounds and had recently had gastric bypass: "Jesus Christ, woman! Go for a walk!"

Me: After we all rolled our eyes at that nurse, I started thinking about how we wouldn't tell people with heroin addiction to just say no--after all, Nancy Reagan was rightly criticized for a simplistic approach to drug addiction. Yet we expect people with chemical imbalances just as serious as those in drug addictions to...what? Push away from the table? Just say "no" to a slice of pie? Why aren't food addictions treated as carefully and aggressively as drug and alcohol addictions?

About a man with a history of clinical depression: "Oh, great. Another whining drama queen."

The only thing to do, when faced with a bigot or a jerk, is to call them out on it. Sometimes you have to call them out repeatedly and loudly, as in the case of the nurse (now thankfully gone) who'd expound on the sinfulness and horribleness of various lifestyles other than her own. Sometimes a raised eyebrow is all it takes. And sometimes, in the case of the nurse who warned me that my patient would "try to give me the AIDS", all you can do is blink and walk away.

Wednesday, December 03, 2008

The patient was pretty typical for rural areas around here: no teeth to speak of, a lifetime of smoking, sun exposure, and manual labor, no education past about the ninth grade. He enjoyed Jerry Springer, betting on cockfights (illegal but still big money-makers around here), and the occasional night out with the boys, bowling.

I was changing his dressing. It was one of those involved dressing changes where you end up next to the bed for half an hour, taking off layers of this and that with your mask and gown on. CNN or CNBC or MSN--one of those channels involving political analysts--was on, and he was making light conversation about cockfighting.

Then the subject changed.

"This Barack Obama..." he began. I mentally steeled myself for what was to follow. People will say anything to a nurse, especially when she's wearing full isolation gear and a mask with an eyeshield.

"This Barack Obama. I'm looking forward to having him as President."

I glanced up and said "mmmmm", which is my usual reaction to patients who talk politics. I was waiting, as it were, for the punch line.

"He looks like a smart guy," the patient continued, "and he seems to be pickin' people for his cabinet who may not necessarily agree with him all the time, but who know their stuff. It'll be nice to have a smart person in office again."

I blinked. "Mmmmm?" I said.

"Well, you know, Bush was all right there for a while, but he kinda got a lot o' yes-men up in around him, and things just ain't been goin' right. Obama may not have a whole helluva lot of experience, you know, but he's doin' all right so far."

I blinked again. I glanced at the patient. "Mmmm? Mmmm."

"I don't think it's elitist," he continued, gesturing at one of the talking heads on the TV, "to have a constitutional expert up in office. I mean, we've seen what the Patriot Act did for civil liberties and for privacy rights, and it's just been a mess. Plus, you add in that whole...whaddya call it? Kyoto protocol? That one we didn't sign? We need to git on that, right now."

I finished taping down the dressing and took off my mask. "You seem to have some pretty unusual views about politics, my friend," I said. This is, after all, a solidly Republican area.

"Well, just because I didn't finish high school don't mean I can't watch CNN and listen to NPR," he replied.

So I sat down for a few minutes. It was the end of the shift and the day had been light, and I had time. We talked about Obama, the recent court challenges to the FLDS out west, and whether or not romance, as a concept, was dead. At the end of it he shook my hand and told me that, if I ever developed an interest in watching roosters fight, I should look him up.